Extended use of esomeprazole improves long-term recurrent peptic ulcer bleeding
Amongst patients with an increased risk of long-term peptic ulcer rebleeding, an extended 36-week course of oral esomeprazole reduced ulcer rebleeding during the first year, according to a study.
In this study, 120 patients with peptic ulcer bleeding and Rockall scores ≥6 were prospectively enrolled, and after an initial 16-week oral proton pump inhibitor (PPI) treatment, patients were randomized to receive oral twice-daily esomeprazole 20 mg (Group D, n = 60) or once-daily (Group S, n = 60) over 36 weeks. After the 36-week course, patients were divided into the PPI-on-demand (n = 32) and PPI-discontinued (n = 77) subgroups. A previous cohort of patients with Rockall scores ≥6 served as the controls (Group C, n = 135), and received only an initial 8- to 16-week oral PPI.
The primary was peptic ulcer rebleeding during the first year and secondary outcomes were peptic ulcer rebleeding during the second year-and-thereafter.
A had a higher proportion of patients in groups D and S had rebleeding-free after the first year. Independent factors contributing peptic ulcer rebleeding during the first year included extended PPI use and American Society of Anesthesiologists classification.
Chiang HC, Yang EH, Hu HM, et al. An extended 36-week oral esomeprazole improved long-term recurrent peptic ulcer bleeding in patients at high risk of rebleeding. BMC Gastroenterol. 2022;22(1):439. doi: 10.1186/s12876-022-02534-0. PMID: 36271335; PMCID: PMC9585769.